Trends of Cutaneous Leishmaniasis, Western Ethiopia: retrospective study

Background Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis and causes skin lesions, mainly ulcers, on exposed parts of the body, leaving life-long scars and serious disability or stigma. In Ethiopia, cutaneous leishmaniasis is primarily caused by Leishmania aethiopica and less often by Leishmania Tropica and Leishmania major. There is a major prevalence gap in study areas. Hence, this study assessed the trends of cutaneous leishmaniasis in the western part of Ethiopia. Methodology A three-year retrospective study (09 October 2018 to 31 January 2022) was conducted by extracting information from the national leishmaniasis register for patients visiting the Nekemte Specialized Hospital (NSH) treatment center, Nekemte, Western Ethiopia. A standard data abstraction checklist was used to review Leishmaniasis records. Data were extracted from national leishmaniasis cases registration book by principal investigators and summarized using Microsoft Excel. All data were entered and analyzed using the Excel Microsoft office package. Results A total of 64 patients were treated for cutaneous leishmaniasis in the area during the study period. About 35(54.69%) cutaneous leishmaniasis cases were males, and the median age for sex was 18.5 years. Most of the cases were among those aged 15-24 years (39.1%) while extreme age groups reported the least. About 35 (54.69%) of cutaneous leishmaniasis cases were from rural areas, and two-thirds (31, 65.96%) of patients were seeking of medical treatment after 3-6 months developing sign and symptoms. One-fourth (17, 26.56%) of CL cases were reported in January followed by August (10, 15.63), and there were no cases reported in June and October. Conclusion The most affected age group are those 15-24 years and those from rural communities. January is months most cases reported and late coming to treatment and needs awareness creation. Author summary Globally, cutaneous leishmaniasis (CL) is the most common form of leishmaniasis which accounts for about 95% of cases. It is an emerging uncontrolled and neglected infection affecting millions yearly. Most CL patients are residing in low- to middle-income countries, where limited healthcare budgets and a large burden caused by other ailments such as malaria, tuberculosis, and HIV (human immunodeficiency virus) are prominent. Accurate disease burden is challenging since misdiagnosis is common, and there are no standard reporting guidelines. There is limited information regarding the magnitude of the cases in low and middle-income countries, including Ethiopia. The lack of epidemiological burden and distribution makes it difficult to advocate for control activities and further research to inform public health policy. This study aimed to assess the trends of CL in the western part of Ethiopia, to fill the gaps in the dearth of information in the area. The study highlighted the distribution of CL cases by gender, age, seasons of the year, and geographical areas (rural or rural). Moreover, we recommend community-based research programs to determine the exact incidence and prevalence of CL cases and associated risk factors in the western part of Ethiopia, particularly in the East Wollega Zone. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was obtained from East Wollega Zonal Health Department, Public and Health Emergency Management (PHEM) case team institutional review board. Consent was also sought from the hospital administration before being involved. Since the data were extracted from secondary data; formal consent (verbal or written) from the parent/guardian was not required. Besides, we used patient identifiable codes to maintain the confidentiality of each patient. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The finding of this study was generated from the data collected and analyzed based on stated methods and materials. The original data supporting this finding are available from the corresponding author on reasonable request. * ALERT : All African Leprosy Rehabilitation and Training Center CL : Cutaneous leishmaniasis NSH : Nekemte Specialized Hospital